It looks like the genetic test will cost us either $0 or around $1,000 each. It’s like a bad game show!
The billing person at the OB’s office warned me that a lot of insurance plans won’t cover these tests if they’re just for family planning. I told that the insurance rep I talked to said it was covered.
The billing lady replied that no rep can 100% assure me I will be reimbursed, and I need to be prepared to pay the whole thing out of pocket.
She did promise to do the pre-authorization. But apparently one of those isn’t a guarantee that the procedure will be covered. (??!!)
I got the procedure codes and called my insurance. The rep put me on hold for a few minutes so that she and her supervisor could check.
According to her, it’s 100% covered with an in-network lab.
I asked if she was sure, since many plans don’t cover this type of thing. She said that my plan is a little different.
Also, it turns out no pre-authorization was required… which the poor billing lady found out after filing all the paperwork and waiting 10 days.
When she called with that news, I updated her about my call. She reiterated that there’s no guarantee, no matter what any rep says. Argh!
I like to think that it will be covered. After all, the rep checked into the specific codes and verified that it’s covered. Even when I pointed out that it’s for family planning. And there’s the fact that no pre-authorization was necessary.
But apparently none of that really means much. So I should probably assume we’ll be coughing up $2,000.
Essentially we have a financial version of Schrodinger’s Cat. Up until I open any bills from my OB, we owe both $0 and $1,000.
My mom, being wonderfully generous and also not averse to grandchildren, has offered to pitch in if any appeal is denied. So there’s that.
Still, I find it ridiculous that I am currently more stressed about the results of the bill than I am about the results of the test itself. And the test may still not tell us anything!
I’m off to schedule my blood draw and have them order another special tube so Tim can get his done.